Tibial Tuberosity advancement (TTA) System: Egbegbe amekokomɔnu aɖe si wozãna tsɔ dzraa aƒemelãwo ƒe lãkusi ɖo
Kpɔkplɔyiɖeme
Anterior cruciate ligament (ACL) nye lãkusi siwo xɔa abi wu le aƒeme ƒe megbeƒu me la dometɔ ɖeka, si wɔnɛ be ƒunukpeƒe ƒe malike, vevesese, kple mlɔeba ƒunukpeƒedɔléle (DJD). Zi geɖe la, ehiãna be woawɔ dɔ na amea be wòali ke eye wòaxe mɔ ɖe nusiwo gblẽ le ƒunukpeƒea ŋu nu. Amekokomɔnu yeye siwo wozãna le aƒemelãwo ƒe ACL ɖɔɖɔɖo me dometɔ ɖekae nye Tibial Tuberosity Advancement (TTA) ƒe ɖoɖo, si va xɔ ŋkɔ le esi wòwɔa dɔ nyuie le ƒunukpeƒewo ƒe dɔwɔwɔ nyuie wu, vevesese dzi ɖeɖe kpɔtɔ, kple dɔwɔwɔ vɔ megbe kuxiwo dzi ɖeɖe kpɔtɔ ta. Le nyati sia me la, míadzro TTA ƒe ɖoɖoa me tsitotsito, eƒe gɔmeɖosewo, eŋudɔwɔwɔ, viɖewo, kple seɖoƒewo.
Anatomy kple ŋutilã ƒe dɔwɔwɔ le aƒemelã ƒe stifle ƒunukpeƒe .
Hafi míaku nu me le TTA ƒe ɖoɖoa ŋu la, ele vevie ŋutɔ be míase avuwo ƒe ƒunukpeƒe ƒe ŋutilã ƒe wɔwɔme kple ŋutilã ƒe dɔwɔwɔ gɔme. Stifle joint la sɔ kple amegbetɔ ƒe klo ƒe ƒunukpeƒe eye eƒe akɔta, afɔkpodzi, kple patella ƒuwoe le eme. ACL la ƒe dɔe nye be wòana ƒunukpeƒea nali ke to mɔxexe ɖe afɔkpodzia ƒe ʋuʋu yi ŋgɔe gome ne wotsɔe sɔ kple afɔkpodzia. Le avuwo me la, ACL la le ƒunukpeƒea ƒe lãkusi me eye collagen ka siwo blaa afɔkpodzi kple afɔkpodzi ƒe ƒuwoe le eme.
Dɔléle si nye ACL ƒe gbagbã le avuwo me .
ACL ƒe gbagbã le avuwo me ate ŋu adzɔ le susu vovovowo ta, siwo dometɔ aɖewoe nye domenyiŋusẽfianu, ƒexɔxɔ, lolo akpa, kamedede, kple nuveviwɔame. Ne ACL la gbã la, ƒu ƒe ƒu la ƒua du yia ŋgɔ, si wɔnɛ be ƒunukpeƒea meganɔa te o, eye wòhea vevesese, dɔdzẽ, kple mlɔeba DJD vɛ. Dɔlékuiwutikewo zazã nyuie, abe gbɔɖeme, atikewo, kple ŋutilãmedɔdada ene, ate ŋu akpe ɖe ame ŋu wòaɖe vevesese dzi akpɔtɔ, gake mekpɔa kuxi si nye ƒunukpeƒe ƒe malikenyenye gbɔ o. Zi geɖe la, ehiãna be woawɔ dɔ na amea be wòali ke eye wòaxe mɔ ɖe nusiwo gblẽ le ƒunukpeƒea ŋu nu.
Gɔmeɖose siwo le TTA ƒe ɖoɖoa ŋu .
TTA ɖoɖoa nye egbegbe amekokomɔnu na aƒemelãwo ƒe ACL ɖɔɖɔɖo si ƒe taɖodzinue nye be woagbugbɔ ƒunukpeƒewo ƒe liƒo aɖo to tɔtrɔ ƒe dzogoe si dzi tibial gbadzaƒea le la me. Tibial plateau nye afɔkpodzi ƒe ƒu ƒe tame si ƒoa ƒu kple afɔkpodzi ƒe ƒu tsɔ wɔa ƒunukpeƒea ƒe ƒunukpeƒe. Le avu siwo ƒe ACL ƒe gbagbã me la, tibial plateau la ƒe gowo ɖiɖina, si wɔnɛ be ƒu si le lãkusia me la ƒua du yia ŋgɔ ne wotsɔe sɔ kple afɔkpodzi ƒe ƒu. TTA ɖoɖoa bia be woalã tibial tuberosity, ƒu ƒe ŋkɔxɔxɔ si le klo ƒe ƒunukpeƒea te, eye woadoe ɖe ŋgɔ ayi ŋgɔ be wòana tibial plateau ƒe dzogoe nadzi ɖe edzi. Wozãa titanium-ka kple gaviwo tsɔ naa ŋgɔyiyia nɔa te, si doa ƒu ƒe dɔyɔyɔ kple fuɖeɖe ɖe ŋgɔ.
Viɖe siwo le TTA ƒe ɖoɖoa ŋu .
TTA ɖoɖoa naa viɖe geɖe wu ACL ɖɔɖɔɖomɔnu xoxowo, abe Tibial Plateau Leveling Osteotomy (TPLO) kple Extracapsular dzadzraɖo ene. Gbã la, TTA ƒe ɖoɖoa ƒe gbeɖiɖi nye biomechanically wu, elabena etrɔa dzogoe si dzi tibial plateau le be wòaxe mɔ na ŋgɔgbe tibial thrust, si nye nusi koŋ gbɔ ACL ƒe gbagbã tso. Evelia, TTA ƒe ɖoɖoa kpɔa ACL si le afima ta, si ɖea afɔku si le kuxiwo abe dɔlékuiwo xɔxɔ, nusiwo wodo ɖe lãme na ame ƒe kpododonu, kple nusiwo wotsɔ dea lãme na ame ƒe dɔmawɔmawɔ me dzi kpɔtɔna. Etɔ̃lia, TTA ƒe ɖoɖoa ɖea mɔ be woatsɔ kpekpeme dzi akpɔtɔ kaba le dɔwɔwɔ vɔ megbe eye woaɖɔe ɖo, si wɔnɛ be ƒunukpeƒewo ƒe dɔwɔwɔ nyona ɖe edzi eye wòɖea ɣeyiɣi si woatsɔ ahayae dzi kpɔtɔna. Enelia, TTA ƒe ɖoɖoa sɔ na avu siwo ƒe lolome kple avu ƒomevi vovovowo le wo si, elabena woate ŋu atrɔ asi le eŋu wòasɔ ɖe ame ɖekaɖekawo ƒe nuhiahiãwo nu.
TTA ƒe ɖoɖoa ƒe seɖoƒewo .
Abe amekokomɔnu ɖesiaɖe ene la, seɖoƒe kple kuxi siwo ate ŋu ado mo ɖa le TTA ƒe ɖoɖoa ŋu. Kuxi si bɔ wue nye be wodona ɖe lãme na ame, si ate ŋu adzɔ le mɔ̃ɖaŋununya ƒe nuteɖeamedzi, dɔléle, alo ƒu ƒe dɔyɔyɔ nyuie ta. Ame ƒe lãme ƒe dɔmawɔmawɔ nyuie ate ŋu ana ƒunukpeƒewo nagali ke o, vevesese, kple alesi wòhiã be woawɔ dɔ na wo be woagbugbɔ ŋku alé ɖe wo ŋu.
Kuxi bubu siwo ate ŋu ado tso TTA ɖoɖoa me dometɔ aɖewoe nye tibial crest fracture, patellar tendonitis, kple joint effusion. Tsɔ kpe ɖe eŋu la, TTA ƒe ɖoɖoa nye amekokomɔnu sesẽ aɖe si bia hehexɔxɔ kple nunya tɔxɛ aɖe, si ate ŋu axe mɔ ɖe eƒe anyinɔnɔ nu le lãwo ƒe dɔdaƒe aɖewo. Gawu la, TTA ƒe ɖoɖoa xɔ asi wu ACL ɖɔɖɔɖomɔnu bubuwo, si ɖewohĩ mate ŋu adzɔ na aƒemelã aɖewo tɔ o.
Ame siwo di be yewoaxɔ TTA ɖoɖoa .
TTA ƒe ɖoɖoa sɔ na avu siwo ƒe ACL ƒe gbagbã kple ƒunukpeƒe ƒe malikenyenye, kpakple esiwo me meniscal tears alo DJD le le ɣeyiɣi ɖeka me. Ame si woate ŋu axɔ nyuie na TTA ɖoɖoa enye avu si ƒe kpekpeme wu kilogram 15, elabena ɖewohĩ ƒu ƒe lolome masu avu suewo si be woatsɔ alé titanium-ti la ɖe te o. Gawu la, womekafu TTA ƒe ɖoɖoa na avu siwo ƒe patellar luxation sesẽ, tagbɔ ƒe cruciate ligament sesẽ (CCL) ƒe gbegblẽ, alo medial patellar luxation o.
Woda akɔ do ŋgɔ na dɔwɔwɔ kple ɖoɖowɔwɔ .
Hafi woawɔ TTA ƒe ɖoɖoa la, ele be woawɔ avu la ƒe numekuku nyuie do ŋgɔ na dɔwɔwɔ nɛ, si me ŋutilã me dodokpɔ blibo, fotoɖeɖe le radio dzi, kple dodokpɔ le nudokpɔƒe hã le. Ele be stifle joint views kple hip views siaa nanye radiographic imaging la be woatsɔ axe mɔ ɖe hip dysplasia alo ƒunukpeƒetetedɔ si nɔa anyi ɖaa nu. Gawu la, ele be amekolaa nawɔ ɖoɖo ɖe amekokoa ŋu nyuie, si me titanium-ti ƒe lolome kple afisi wòle, tibial tuberosity ƒe ŋgɔyiyi ƒe agbɔsɔsɔme, kple atike si wua alɔ̃dɔdɔ kple vevesesenutsitike ƒomevi.
Amekokomɔnu .
TTA ƒe ɖoɖoa nye amekokomɔnu si biaa mɔ̃ɖaŋununya si bia hehexɔxɔ kple nunya tɔxɛ. Wowɔa amekokoa le atike si naa alɔ̃dɔdɔ nu, eye woɖoa avu la ɖe akɔta ƒe akɔta. Amekolaa ɖea lãkusi ƒe ʋuka si me ʋu le la ɖe go eye wòɖea patellar tendon la ɖa le tuberosity la me. Emegbe wozãa aŋe tɔxɛ aɖe tsɔ lãa tuberosity la, eye wotsɔa titanium atɔ ɖe lãɖeɖea dzi. Wozãa gaviwo tsɔ léa atɔa ɖe te, eye wogbugbɔa patellar tendon la dea tuberosity la me. Emegbe wodzroa ƒunukpeƒea me be eli ke hã, eye wozãa sutures alo staples tsɔ xea lãkusia ƒe akpa si woɖe la.
beléle na ame le dɔwɔwɔ nɛ vɔ megbe kple eƒe nɔnɔme ɖɔɖɔɖo .
Ne wowɔ dɔ nɛ vɔ la, wotsɔa vevesesenutsitike kple dɔlékuiwutikewo dana ɖe avu la dzi, eye woléa ŋku ɖe ƒunukpeƒea ŋu be evuvu, vevesese, alo dɔlékuiwo hã. Woɖea mɔ na avu la be wòada kpekpeme ɖe abɔ si ŋu dɔlélea le dzi le amekokoa megbe teti, gake wokafua dɔwɔwɔ si ŋu woxe mɔ ɖo le kwasiɖa ʋɛ gbãtɔawo me. Ele be woatsɔ ka abla avu la eye woaxe mɔ nɛ be wòagati kpo, aƒu du, alo anɔ atrakpuiwo liam o. Ele be ŋutilãmedɔdada, si me kamedede siwo me wowɔa nu le le mɔ si mewɔa dɔ o nu kple kamedede si dzi wokpɔna hã le, le ŋkeke ʋɛ aɖewo megbe le amekokoa megbe be wòana ƒunukpeƒewo nawɔ dɔ nyuie wu eye woaxe mɔ ɖe lãmekawo ƒe dɔmawɔmawɔ nyuie nu. Ehiã be amekolaa gbɔ yiyi edziedzi nayi edzi akpɔ dɔyɔyɔ ƒe ɖoɖoa eye woade dzesi kuxi siwo ate ŋu ado tso eme.
Nyanuwuwuw
Tibial tuberosity advancement (TTA) ɖoɖoa nye egbegbe amekokomɔnu na aƒemelãwo ƒe ACL ɖɔɖɔɖo si ƒe taɖodzinue nye be woagbugbɔ ƒunukpeƒewo ƒe liƒo aɖo anyi to tibial plateau ƒe dzogoe tɔtrɔ me. TTA ɖoɖoa naa viɖe geɖe wu ACL ɖɔɖɔɖomɔnu deŋgɔwo, siwo dometɔ aɖewoe nye biomechanical soundness, ACL si nye afimatɔ la ta kpɔkpɔ, kple dɔwɔwɔ vɔ megbe gbugbɔgaɖɔɖo kaba. Gake seɖoƒe kple kuxi siwo ate ŋu ado mo ɖa le TTA ɖoɖoa ŋu, eye ebia hehexɔxɔ kple nunya tɔxɛ. Eyata ele be woatso nya me be woawɔ TTA ƒe ɖoɖoa le dodokpɔ tsitotsito si wowɔ do ŋgɔ na dɔwɔwɔ na wo kple aɖaŋuɖoɖo kple lãwo ƒe dɔléle ŋuti nunyala bibi aɖe megbe.
